I would say it started all over again this week, but the truth is it never ended. This was just the next step.

My appointment was at 11, vital signs, consent forms and a lot of waiting. Then a little exam room, the familiar upholstered table with a paper sheet.  Lie on my stomach and wait some more.  A lot of idle chatter about the weather and then she jams a sharpened metal drinking straw into my hipbone.  Poke in a needle and draw out some fluid, and then some kind of gizmo that reaches in and snips off some bone marrow. They tell me it’s supposed to be painful. And this time it fulfilled that promise.

Then a band aid and I walk out to the car and drive home.

I’ve had five or six bone marrow biopsies since I was diagnosed with chronic lymphocytic leukemia six years ago. You would think by now they could just go in the same hole, but I guess it heals shut.  Usually my doctor orders a biopsy because he “wants to see what’s going on in the marrow,” whatever that means. This one is a little different. This is a precursor to starting treatment.

If you’ve been reading this blog for the last five years or so, you are a) my wife, or b) tired of hearing the whole story all over again. And there’s a lot of that going around. I’m tired of it too.

I’m in stage four now.

So the next step will be to get the results and then talk about the options. We did this five years ago and he recommended a trial of a chemo combination. It kicked the leukemia back but also left me without a lot of good white cells or platelets. And they never have really come back to normal.

And finally he’ll say he’s especially partial to this clinical trial or that. Because the truth is I’m part patient and part subject and while I’m pretty sure he is choosing the thing that’s best for me, there’s a part of me that thinks he just wants to see what will happen with the newest concoction.

That’s when they drag out the paperwork. There’s a chance of complications ranging from hangnails to death. And since it’s a clinical trial I have to agree to come by the clinic once a week for a blood test.

My preference is to put it off until the first of the year. No one wants to hang an intravenous bag on their Christmas tree. I don’t know what it will be and I don’t know how. But I do know why. Because my doctor says I should. I feel fine, and always have. But somewhere around 40 percent of the white cells running through my veins are leukemia cells. And nobody wants that.